A novel Lumbo-Peritoneal Shunt System Including a Gravitational Unit: First Experiences and Clinical Perspectives

In Europe and North America, hydrocephalus is commonly treated with ventriculo-peritoneal shunts (VPS), while in Japan and other Asian countries, lumboperitoneal shunts (LPS) are preferred. Despite the risk of overdrainage, no adaptable valve with an integrated gravitational unit was available for LPS until recently. We report on a novel modular valve system designed for LPS. We retrospectively analyzed 24 patients who underwent LPS implantation between March 2023 and July 2024. The median age was 64.5 years, with various etiologies including posthemorrhagic hydrocephalus (41.7%), idiopathic normal pressure hydrocephalus (37.5%), and idiopathic intracranial hypertension (8.3%). LPS was also used as salvage therapy in three cases with complex cranial wounds. Relevant complications requiring reoperation occurred in 16.7% of patients, with peritoneal catheter dislocation accounting for 75% of these cases. Overdrainage was observed in 20.8% of patients, but only one serious event necessitated LPS removal. Follow-up showed improvements in gait and vision for iNPH and IIH patients, respectively. This study is the first to use the novel LPS with an integrated gravitational unit, showing promising outcomes across various hydrocephalus etiologies and highlighting its potential as a salvage option for complex cases. Further research with larger cohorts is needed.